血液瘤扩张严重程度和结果之间的关联及其与基线脑内出血量相互作用
Andrea Morotti1, Gregoire Boulouis2, Jawed Nawabi2
1From the Neurology Unit (A.M.), Department of Neurological Sciences and Vision, ASST-SpedaliCivili, Brescia, Italy; Neuroradiology Department (G. Boulouis), University Hospital of Tours, CEDEX 09, France; Department of Radiology (CCM) (J.N.), Charité-Universitätsmedizin Berlin, Campus Mitte, Humboldt-Universität zu Berlin, Freie Universität Berlin, Berlin Institute of Health; Berlin Institute of Health (BIH) (J.N., F.S.), BIH Biomedical Innovation Academy, Germany; Department of Neurology (Q.L.), The First Affiliated Hospital of Chongqing Medical University; Department of Neurology (Q.L.), The Second Affiliated Hospital of Anhui Medical University, Hefei, China; Department of Neurology (A. Charidimou), Boston University Medical Center and Boston University School of Medicine, MA; Neurology Department (M.P.), University Hospital of Tours, CEDEX 09, France; Department of Neuroradiology (F.S.), Charité-Universitätsmedizin Berlin, corporate member of Freie Universität Berlin, Humboldt-Universität zu Berlin, Germany; Division of Neurology (A.S., A.H.K.), McMaster University/Population Health Research Institute, Hamilton, Ontario, Canada; U.O. Neurologia d'Urgenza e Stroke Unit (F.M., A. Cavallini), IRCCS Fondazione Mondino, Pavia; Department of Biomedical Experimental and Clinical Neuroradiology (G. Busto, E.F.), University of Firenze, AOU Careggi; Stroke Unit (F.A.), AOU Careggi, Firenze; IRCCS Istituto delle Scienze Neurologiche di Bologna (L.B., S.G., A.Z.),UOC Neurologia e Rete Stroke Metropolitana, Ospedale Maggiore; IRCCS Istituto delle Scienze Neurologiche di Bologna (L.S.), Unità di Neuroradiologia, Ospedale Maggiore, Italy; J.P. Kistler Stroke Research Center (A.D.W., M.E.G., A.V., S.M.G., J.R., J.N.G.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston; Clinica Neurologica (M.L., I.C.), Dipartimento di Scienze Biomediche e Chirurgico Specialistiche, Università degli studi di Ferrara, Ospedale Universitario S. Anna, Ferrara; Department of Clinical and Experimental Sciences (A.P.), Neurology Unit, University of Brescia, Italy; Division of Neurocritical Care and Emergency Neurology (J.R.), Department of Neurology, Massachusetts General Hospital, Harvard Medical School; and Henry and Allison McCance Center for Brain Health (J.R., J.N.G.), and Department of Emergency Medicine (J.N.G.), Massachusetts General Hospital, Boston. andrea.morotti85@gmail.com.
严重的血瘤扩张 (HE) 显著预测大脑内出血 (ICH) 的不良结果. 这种风险在初始ICH体积较小的患者中最为明显,指导向治疗.
科学领域:
- 神经学 神经学
- 神经外科 神经外科
- 放射学 放射学是一门学科.
背景情况:
- 血瘤扩张 (HE) 是大脑内出血 (ICH) 进展和患者结局的关键因素.
- 了解不同高等教育学位的预后影响对于治疗开发至关重要.
研究的目的:
- 分析不同程度的血液瘤扩张对脑内出血患者的预后影响.
- 确定ICH后功能不良结果的预测因素,重点关注HE严重程度.
主要方法:
- 在8个国际学术机构对2,163名ICH患者进行了回顾性分析.
- 血瘤扩张的分类为相对 (rHE) 和绝对 (aHE) 类别,具有定义的严重程度.
- 后勤回归分析,以探索功能性结果差的预测因素 (90天的mRS 4-6).
主要成果:
- 严重的aHE或rHE更频繁地发生在不良结局的患者中 (分别为13.9%与6.5%和18.3%与7.2%).
- 严重的HE (aHE和rHE) 与糟糕的结果显著相关 (OR 1.73-1.98,p < 0.002).
- 这种关联仅在初始ICH体积<30毫升的患者中具有意义.
结论:
- 严重的血液瘤扩张是ICH中功能不良结果的强有力的预测因素.
- 严重的HE的预后影响在初始ICH体积较小的患者中最为显著.
- 结果可以为临床试验设计和患者选择抗扩张疗法提供信息.
相关概念视频
Hemorrhagic Stroke l: Introduction
Hemorrhagic Stroke ll: Pathophysiology
Increased Intracranial Pressure l: Introduction
Increased Intracranial Pressure ll: Pathophysiology
Cerebral Edema l: Introduction
Cerebral Edema ll: Pathophysiology


